Procrasinating from procrastination.

So part of medicine is completing a list of tasks for every weekly case called 'Learning Objectives', which we have shortened to yet another acronym - LO's. A friend of mine was commenting that she's beginning to hate those two letters, which I immediately agreed with before realising that my surname starts with both. *Face-palm*

This past weekend I have been doing the list of LO's for a case about a woman with a heart attack. One of the LO's reads like this:
8. Experience in a simulated form how to answer a request by a critically ill patient for their prognosis.
My thought process went a little like the following:
- I think I need to watch a film on this.
- How does one put video on paper?
- What does simulate mean? And why would I want to experience it?
- And why would I want to experience telling a critically ill person they're going to die?
- Would the correct answer be: Yell and point at something behind them and then make a quick getaway while they're looking away?

The next LO was almost as bad:
9. Experience in a simulated form how to ethically and legally request post mortem permission from next-of-kin, after a patient’s sudden death.
- Ask and then duck as the family member takes an almighty swing at your head.
- Deligate, deligate, deligate. If you're a consultant, shaft the responsibility to the registrar, if you're a registrar give it to the intern, if you're the intern give it to a medical student. If you're a medical student... well, remember that everythings for the sake of learning and unless you actually kill or maim someone, you're probably good to go. Or just run and hide.

A third year medical student (3YS) who I work with was telling me a story about her day in the surgical ward of our local hospital.
She had recently run into a registrar earlier that day and was committed to not getting noticed for the rest of the day. So picture this:
*3YS stands flat against the wall, believing that in no way possible can she draw attention to herself*
Other student: Hey can you lend me a pen? (or some other meaningless question)
3YS: Sure
She lifts her elbow slightly away from where she had them stuck to her sides, just in time to have a Consultant race around the corner, run into her still form and spill coffee all over his expensive clothes.
Consultant: WHAT THE HELL DO YOU THINK YOU'RE DOING?!
*3YS flinches*
Consultant: WHAT THE HELL AM I MEANT TO DO NOW?!!
*Storms away*
Intern: If it was going to happen to anyone today, it was going to happen to you.

Things to do this week:
- LOs
- Practical revision
- DHC report
- Hospital report
- Go to the beach
- Go to an engagement party on Saturday
- Pay bills.
- Don't get distracted by reading, writing, new episodes of Gossip Girl, House and Grey's Anatomy

... Easier said than done.

I have a dream.

Or rather, I had the first of what is likely to become many dreams.

There was no preemptive attack of stress, nor any particular moment that I could pinpoint as the reason that I woke up about a week ago from a terrible dream.

In my dream I had just finished my final case in the renal block of PBL. To anyone who doesn't attend my med school, this probably seems like no biggy, but what I should probably mention is that renal is the final block of cases prior to exams. So in my dream, I've finished renal and realised, "holy crap! I have a week until exams, and I'm sure I had only just started respiratory a couple of weeks ago and how exactly did I skip forward to this point in time."

I woke up the next morning feeling distinctly unsettled. As a result I am starting to feel the stress of exams which begin in six weeks.

One of my exams is called an 'OSCE'. Don't ask me what that stands for, because medicine is all about the acronyms and mnemonics. For example, a way to diagnose the psychological development of an adolescent is by using HEAADSSS (Home, Education, Activities, Affect, Drugs/Alcohol, Sexual history, Suicidality, Safety). Notice the multiple A's and multiple S's, this is a common thing in medicine and entirely destroys a doctor's future hope of winning a spelling bee.

But back to an OSCE, this basically examines a students ability to perform clinical skills. A first year's OSCE consists of history-taking and using our stethoscopes to listen to different sounds. A fourth year's OSCE consists of giving needles; I wish I was one...

My two housemates are both third year medical students at my university and one of them (HM1) offered to run me through a cardiovascular examination. It went a little like the following:
HM1: Where would you start?
Caitie: Well I guess I would start with a general inspection of the patient.
HM1: Which would consist of?
Caitie: Oh GOD, the pressure, is anyone else feeling hot in here?
Caitie: I would look at.... (and I listed several correct answers)
HM1: Then where would you move to?
Caitie: The hands, where I would look for janeway lesions and osler nodes
*Caitie beams proudly as she regurgitates terms she heard the other day in the hospital.*
HM1: Which are indicative of?
Caitie: Janeway lesions are because of... congestive heart failure?
HM1: Not likely.
Caitie: One of them's because of congestive heart failure. Osler nodes, for sure.
HM1: Nope. Can you think of what is?
Caitie: Splinter haemorrhages, they're definitely because of congestive heart failure.
*Looks hopeful*
HM1: Er...
Caitie: Then what do they all mean? These is like jeopardy but without the prizes!!
HM1: They are all because of infective endocarditis.
Caitie mutters: ... same thing.

The rest of the conversation went a little like that and so I rewarded myself by watching the new House episode. A prize I believe can only aid me in my future career choice.